Ben Nsir Atef, Thai Quoc-Anh, Kassar Alia Zhani, Ben Said Imed, Jemel Hafedh
Department of Neurosurgery, Fattouma Bourguiba University Hospital-University of Medicine of Monastir, Monastir, Tunisia.
Department of Neurosurgery, The Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
World Neurosurg. 2015 Dec;84(6):2076.e13-7. doi: 10.1016/j.wneu.2015.07.049. Epub 2015 Jul 31.
Gliosarcomas are rare, malignant primary brain tumors, most commonly located in the temporal lobe, that contain both glial and mesenchymal elements. Gliosarcomas located within the cerebellum are exceedingly rare. The previously unreported finding of a cerebellar gliosarcoma concurrently with an extracranial metastasis to the lungs is discussed here.
A 57-year-old man presented with a 3-month history of chest pain, weight loss, headaches, and vomiting. Physical examination revealed a left cerebellar dysfunction, and the radiological work-up revealed a 6 × 6-cm right apical pulmonary tumor and a 4 × 3.5 × 3.8-cm peripherally enhancing left cerebellar mass. On the basis of a smoking history in the setting of a lung lesion and cerebellar mass, the presumptive diagnosis was primary lung cancer with metastasis to the cerebellum. Gross total resection of a firm pseudo-encapsulated cerebellar mass was performed. The microscopic features and the immunohistochemical profile confirmed the diagnosis of Gliosarcoma. The thoracic lesion was removed subsequently, and pathology confirmed it as an extracranial metastasis from the cerebellar gliosarcoma. Adjuvant radiation and chemotherapy were then administered. No clinical or radiographic evidence of recurrence was observed during one year of follow-up monitoring.
To the best of our knowledge, a primary infratentorial gliosarcoma with extracranial metastases has not been previously described.
胶质肉瘤是一种罕见的原发性恶性脑肿瘤，最常见于颞叶，包含胶质和间充质成分。位于小脑的胶质肉瘤极为罕见。本文讨论了此前未报道的一例小脑胶质肉瘤同时伴有肺颅外转移的病例。
一名57岁男性，有3个月的胸痛、体重减轻、头痛和呕吐病史。体格检查发现左侧小脑功能障碍，影像学检查显示右肺尖有一个6×6厘米的肿瘤，左侧小脑有一个4×3.5×3.8厘米的周边强化肿块。鉴于有吸烟史以及肺部病变和小脑肿块，初步诊断为原发性肺癌伴小脑转移。对一个坚实的假包膜性小脑肿块进行了全切除。显微镜下特征和免疫组化结果证实为胶质肉瘤。随后切除了胸部病变，病理证实为小脑胶质肉瘤的颅外转移。然后给予辅助放疗和化疗。在一年的随访监测中未观察到复发的临床或影像学证据。
据我们所知，此前尚未描述过原发性幕下胶质肉瘤伴颅外转移的情况。
